SARS CoV-2 IgG Research Articles

Inflammatory cytokine responses in pediatric tuberculosis with or without SARS-CoV-2 seropositivity

To characterize the inflammatory cytokine profiles in children with TB in the presence and absence of SARS-CoV2 seropositivity. This study evaluated cytokine responses in two groups of children with TB: CoV2+ (TB and SARS-CoV2 seropositive) and CoV2- (TB and SARS-CoV2 seronegative). Each group had 30 children, and cytokine levels were measured at baseline, months 3and 6. At baseline, CoV2+ children exhibited significantly elevated levels of cytokines, including IFN-γ, IL-2, TNFα, IL-1α, and IL-6, and reduced levels of IL-1β and IL-18, compared to CoV2- children. No significant differences in cytokine levels between the groups were observed at months 3 and 6. Additionally, a general decline in cytokine levels was noted over the course of treatment in both groups. A positive correlation was found between most cytokines and SARS-CoV2 IgG spike protein levels at baseline and at month 3 in the CoV2+ group. This study is one of the first studies to characterize the systemic inflammatory responses in SARS-CoV2 seropositive and seronegative children with TB from a TB endemic country. The findings enhance our understanding of the immunopathogenesis of TB and SARS-CoV2 seropositivity in children and may inform future therapeutic strategies.

Multisystem Inflammatory Syndrome in Neonates Associated with COVID-19 in Neonatal ICU of a Tertiary Care Hospital.

Neonatal multisystem inflammatory syndrome (MIS-N) is a unique disease of neonates described in several case reports from all over the world with a myriad of presentations and the emergence of new cases. Retrospective case series. Place and Duration of the Study: Department of Paediatrics, Fazaia Medical College, Pakistan Air Force Hospital, Islamabad, Pakistan, from December 2021 to November 2022. The study was conducted on neonates who were managed as MIS-N in the neonatal ICU. Data were collected and analysed on SPSS version 24. Patients in this study ranged from newborns to 13 days of age with a mean age of 3.27 ± 4.29 days and average gestational age of 35.18 ± 3.67 weeks. Among these neonates, 7 (63.6%) had bleeding diathesis, 11 (100%) had seizures, 8 (72.2%) presented with haemodynamic instability and shock, and 7 (63.3%) had signs of heart failure. All neonates (100%) had markedly raised SARS-CoV2 IgG antibodies, CRP, ferritin, D-dimers, interleukin 6, procalcitonin, 10 (90.9%) had hypoalbuminemia, and 7 (63.3%) had deranged coagulation profile. Cardiac involvement was seen in all neonates (100%) with raised proBNP and myocardial dysfunction on echocardiography. Pulmonary hypertension was present in 6 (54.4%) neonates. High mortality was observed at 6 (54.5%) among which 4 (66.6%) were premature neonates. MIS-N is a new disease entity which is still under research. There is a high propensity for cardiovascular system involvement and higher mortality among preterm neonates. Neonatal multisystem inflammatory syndrome (MIS-N), Multisystem inflammatory syndrome in children (MIS-C), SARS-CoV2 infection, SARS-CoV2 spike protein, SARS-CoV2 IgG antibodies.

Inflammatory and cytotoxic mediators in COVID-19 patients and in ChAdOx1 nCoV-19 (AZD1222) vaccine recipients

Immunological and cytotoxic mediators are induced in natural infection and are essential for the effectiveness of vaccination. Vaccination is useful to prevent the spread of SARS-CoV-2 and limit the morbidity/mortality of COVID-19. ChAdOx1 nCoV-19 is one of the most widespread vaccines in the world. We compared the detection of anti-S1 SARS-CoV2 IgG and the profile of inflammatory and cytotoxic responses of patients who developed different clinical outcomes of COVID-19 with individuals previously exposed or not to the virus received the first and booster doses of ChAdOx1 nCoV-19. Plasma from 35 patients with COVID-19 and 11 vaccinated were evaluated by multiplex assay. Here, no vaccinated subjects had serious adverse effects. Those vaccinated with a booster dose had higher anti-S1 IgG than mild/moderate and recovered patients. Critically ill and deceased patients had IgG levels like those immunized. By univariate analysis, IL-2, IL-17, and perforin do not differentiate between patients and vaccinated individuals. Granzyme A increased at dose 1, while patients had their levels reduced. High levels of granulysin, sFas, and IL-6 were detected in the deaths, but after vaccination, all were declined. The multivariate analysis supports the role of IL-6 and granulysin as associated and non-confounding variables related to the worst clinical outcome of COVID-19, but not sFas. Our data confirm the ability of the ChAdOx1 vaccine to produce specific antibody levels up to booster time. Furthermore, our data suggest that the vaccine can regulate both the hyper-production and the kinetics of the production of inflammatory and cytotoxic mediators involved in the cytokine storm, such as granulysin and IL-6.

Seroprevalence of SARS-CoV-2(Covid-19) Antibody Among Blood Donors in a Tertiary Care Centre in South India

Introduction The novel severe acute respiratory syndrome virus 2 (SARS-CoV-2), which is responsible Coronavirus disease (COVID-19), spread worldwide from China, causing a pandemic from late December 2019. Due to the high proportion of asymptomatic or mild infections (approximately 80%), data restricted to laboratory-confirmed cases do not capture the true extent of the spread or burden of the virus, or its infection-fatality ratio. Therefore, serological detection of specific antibodies against SARS-CoV-2 can better estimate the true number of infections. The current study aims to estimate the seroprevalence of SARS-CoV-2 antibodies among the whole blood donors without any prior COVID-19 history or symptoms. Objective To determine seroprevalence of SARS-CoV-2 (COVID-19) antibody (IgG and IgM) among asymptomatic healthy blood donors. Methods This was a cross sectional study conducted between March and July, 2021 among 300 blood donors without any prior COVID-19 history or symptoms who came to a tertiary care, multispecialty hospital in south India. Any donor who had recently travelled abroad or donors who had received COVID-19 vaccine are excluded from the study. 3 ml venous blood was drawn in EDTA tube from participants and was tested by “Access SARS CoV-2 IgG assay” and “Access SARS CoV-2 IgM assay” by UniCel DxI 800 Immunoassay analyzer (Beckman coulter). The Access SARS CoV-2 IgG assay and the Access SARS Cov-2 IgM assay detect antibodies to the Receptor Binding Domain (RBD) of the Spike Protein. Result was reported as Reactive if Signal/Cut-off (S/CO)>1.0 and non-Reactive if S/CO <1. Data was collected and entered into excel sheets and was analyzed by using the software SPSS version 25. Results A total of 300 healthy blood donors were included. The study reported seroprevalence of 15.3% for IgG and 4.3% for IgM (95%CI) among asymptomatic whole blood donors. No significant difference was observed across age groups, diet, BMI, ABO/Rh blood type or Ayurveda/homeo immune medicine intake with respect to IgG and IgM reactivity. Conclusion 15% of blood donors were seroconverted for COVID-19 during second wave. This reflects widespread seroprevalence in the adult population. Real-time seroprevalence studies will help to know the herd immunity among the blood donors which will assist in knowing the COVID-19 transmission dynamics and distribution of immunity levels at a particular point in time.

P-070 SARS-CoV2 antibody isotypes in seminal fluid of vaccinated men

Abstract Study question Are SARS-CoV2 antibody isotypes detectable in seminal fluid of vaccinated men Summary answer Systemic circulating SARS-CoV2 antibodies are likely to be precluded from transport to seminal plasma following vaccination in males What is known already Expedited development of SARS-CoV-2 vaccines led to public concerns regarding impacts of the novel vaccine on gametes in patients seeking assisted reproduction. Recent studies on ovarian follicular fluid from women post SARS-CoV2 infection or BNT162b2 mRNA vaccination show similar levels of SARS-CoV2 IgG antibodies in follicular fluid as those found in serum. To our knowledge, no study to date has examined if SARS-CoV2 antibody isotypes are detectable in seminal fluid of vaccinated men. Study design, size, duration This was a longitudinal cohort study of 17 normospermic male patients attending a fertility clinic associated with a tertiary university maternity hospital. Semen and matched peripheral blood samples were collected prior to vaccination (t = 0), within 46 + 18.9 hours of vaccine completion (acute; t = 1) and at 88.4 + 12 days (3 months; t = 2) post vaccination. Participants/materials, setting, methods Serum and seminal plasma anti-SARS-CoV-2 spike isotypes (IgA, IgM and IgG1) and immune factors (IL-6, IL-8, IL-10, IFN-γ, TNF-α, IP-10; CXCL10, MCP-1, CCL2) were analysed using ELISA-based approaches at three time points. To rule out potential factors present in seminal plasma that could interfere with IgG detection, a commercial positive anti-Spike control was used to confirm detection in the ELISA assay. Self-reported symptoms and sperm parameters including count, motility, morphology, DNA damage were also quantified. Main results and the role of chance All semen samples were found to be negative for anti-SARS-CoV2 spike antibodies at all three time points indicating that systemic antibodies are likely precluded from transport to seminal plasma. Four out of 17 (23.5%) serum samples were negative for all three isotypes (IgM, IgA, IgG1) at < 72 hours post-vaccine completion, while one patient remained negative for all antibodies at 3 months post-vaccine. No global change from baseline was seen in reported symptoms, mean semen volume, semen pH, sperm concentration, motility, morphology or DNA damage in the acute or long phase. Two men showed a clinically relevant reduction in sperm motility alone in the acute phase that returned to normal by 3 months. Seminal plasma MCP-1 levels showed an acute but transient elevation post-vaccine, while IL-8 was marginally increased 3 months after completion of vaccination. Our findings also indicate a modest, positive correlation between serum levels of the anti-inflammatory cytokine IL-10 and self-reported symptoms in the acute post-vaccine period, with no correlation between serum IL-10 levels and change in sperm parameters from t = 0 to t = 1. Limitations, reasons for caution This study included a small population of only 17 men, all of whom were normospermic. Responses in men with subnormal baseline sperm parameters may differ and thus would be helpful to explore. Wider implications of the findings Our results show no significant adverse effect of vaccination. There may be temporary decline in sperm motility which could be more significant in men with poor baseline parameters. Further larger studies with inclusion of men with abnormal baseline parameters would be valuable to support timing of vaccination and treatment. Trial registration number not applicable

CROSS SECTIONAL STUDY OF COVID 19 CONVALESCENT PLASMA (COPLA) DONOR CHARACTERISTICS

Background: Although many trials are currently investigating the safety and efcacy of convalescent plasma (CP) in critically ill COVID-19 patients, there is a paucity of ongoing and published studies evaluating the CP donors' side. In this regard, this study was aimed to nd out how SARS-CoV2 IgG antibodies are inuenced by demographic and clinical characteristics of donors such as age, sex, ABO/Rh blood group, disease severity, post recovery duration, ethnicity. After approval from the IEC Material & Methods: and consent from the study participants, the study was performed in Department of Pathology and Blood Bank of Sri Aurobindo Medical College and PG Institute, Indore (M.P) on a total of 785 COVID-19 recovered patients. A total Results: of 785 COVID-19 recovered patients were telephonically contacted for COPLA donation, out of which 103 donor candidates refused for the plasma donation while 82 donors were deferred by blood bank authorities for convalescent plasma donation. 600 donors successfully donated convalescent plasma in the present study. The most common reason for refusal of COPLA donation by the donors was Fear of reinfection (26.2%) followed by diabetes mellitus on insulin (16.5%). Whereas low antibody titre (53.7%) was the most common reason for COVID- 19 COPLA donor deferral in the present study. Majority were in age group 26-35 with higher prevalence of males. Donors' age and COVID-19 severity were positively associated with greater antibody responses. The awareness of CP donor characteristics, post-screening deferrals, and c Conclusion: orrelates of antibody values with age, gender, body weight, severity of COVID-19 disease and blood groups will help improve collection outcomes and give better preparedness for future recurrent waves due to evolution of more virulent SARS-CoV-2 strains and ll treatment gap till availability of more specic treatment.

A pilot study: Validation of dried blood spots (DBS) to assess SARS-CoV2 IgG antibody immunoassays in underserved minority population

Underserved, low-income, rural and certain migrant populations have greater risks and higher incidences of Coronavirus disease 2019 (COVID-19) than more privileged populations. Current in-person testing methods have limitations, namely exposure risk, a requirement of accessible transportation to healthcare facilities, and economic barriers. Dried blood spots (DBS) samples are widely used for diagnostics in many infectious diseases including Rabies, HIV, Ebola viruses and newborn screening. Our goal was to determine the accuracy and reliability of measuring COVID-19 IgG in DBS compared to paired plasma samples in a population with known infection status and then apply this method to screen an underserved minority population with high risk for COVID-9 infection (unvaccinated, pregnant, low income, Hispanic women). To optimize the assay, we tested 22 nonpregnant women, 12 with positive prior PCR testing for SARS-CoV2 infection and 10 with negative PCR results. After the assay was optimized, we tested the assay in a vulnerable population with a high risk for infection, who were 52 Hispanic pregnant women without prior PCR testing or vaccination. DBS assay results in both groups showed an agreement of 100% with paired plasma samples. The availability of a DBS assay could enable people who may not have access or transportation to healthcare facilities to use DBS as a COVID-19 testing vehicle.

Potent SARS-CoV2-specific T-cell response in asymptomatic hemodialysis patients with hidden COVID-19 infection history.

COVID-19-related immune responses in patients with end-stage renal disease (ESRD) are characterized in detail by the humoral response, but their cellular immunity has not been clarified. Here, we evaluated virus-specific T cells in parallel with serology-related tests. In this study, 104 ESRD patients at the hemodialysis ward of Imam Reza hospital at Tabriz (Iran) were enrolled. After blood sampling, SARS-CoV2-specific humoral and cellular immune responses were evaluated by SARS-CoV2-specific IgM/IgG ELISA and peptide/MHCI-Tetramers flow cytometry, respectively. Our results showed that 14 (13.5%) and 45 (43.3%) patients had specific SARS-CoV2 IgM and IgG in their sera, respectively. Immunophenotyping for SARS-CoV2-specific CD8+ T lymphocytes revealed that 68 (65.4%) patients had these types of cells. Among SARS-CoV2-specific CD8+ T lymphocytes positive subjects, 13 and 43 individuals had positive results for specific SARS-CoV2 IgM and IgG existence, respectively. Also, there was a relationship between specific SARS-CoV2 IgM (p=0.031) and IgG (p < 0.0001) existence and having SARS-CoV2-specific TCD8+ lymphocytes in the studied population. Despite not having clinical symptoms, a high rate of SARS-CoV2-specific T-cell response in asymptomatic ESRD patients may reveal a high burden of asymptomatic COVID-19 infection in these patients.

Comparison of SARS-CoV2 IgG Antibody Levels in Health Workers with and without a History of COVID-19 Infection after Heterologous Vaccination at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Background: The COVID-19 pandemic, which has spread very quickly, has created crises in all aspects of life around the world. The administration of the COVID-19 heterologous vaccine in Indonesia is prioritized for high-risk groups, one of which is health workers. This study aimed to determine the comparison of quantitative IgG antibody levels for SARS CoV2 between health workers with and without a history of being infected with COVID-19 after heterology vaccination at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.&#x0D; Methods: This study was a cross-sectional analytic observational study. A total of 64 subjects participated in this study. Data analysis was carried out with the help of SPSS software in univariate and bivariate.&#x0D; Results: SARS-CoV2 IgG antibody levels with and without a history of being infected with COVID-19 after heterologous vaccination did not find a significant difference in IgG levels between the two groups. However, the quantitative IgG levels of SARS-CoV2 in the infected history group were greater, namely 4834.25 AU/mL, compared to no history of COVID-19 infection of 3833.35 AU/mL&#x0D; Conclusion: There is a difference in the average SARS-CoV 2 IgG between subjects with a history of being infected with COVID-19 and without a history of COVID-19 at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, although statistically, it is not significantly different.

Multisystemic Inflammatory Syndrome in Children: A Retrospective Study

Introduction: Pediatric Multisystem Inflammatory Syndrome linked to temporal with SARS-Cov2 is a new hyper inflammatory disorder that affects children with Covid-19 infection. It usually occurs 2 to 6 weeks following illness or exposure.&#x0D; Materials and Methods: Descriptive retrospective study of a cohort of 11 patients with MIS-C treated in the pediatric department of the Mohamed V military hospital in Rabat between December 2020 and September 2021. We analyzed the epidemiological, clinical, biological, imaging, therapeutical and evolutionary data of our patients.&#x0D; Results: The average age is 9 years; the sex ratio is 1,2. The average exposure gap is 3.7 weeks. All patients presented with fever with multivisceral involvement, 81% presented digestive signs, 100% mucocutaneous signs, 63% cardiac signs and 54% neurological signs. Inflammatory markers were consistently high. Anemia (91%), neutrophilic leukocytosis (91%), lymphopenia (73%) are constant. The Covid-19 RT-PCR was negative and the SARSCov2 IgG serology testing was positive in all our patients. 54% of our cases have echocardiographic signs. Treatment was based on polyvalent intravenous immunoglobulins (IVIG) in all cases associated with corticosteroid therapy in 45% of cases and antiplatelet therapy in 91% of cases. The outcome was favorable in all of our patients.&#x0D; Conclusion: MIS-C should be considered in children with fever, rash, headache, tachypnea, and gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain. Cardiogenic shock is the main complication. IVIG and systemic corticosteroid therapy are the fundament of treatment.

Non-contrast cardiac magnetic resonance imaging after SARS-CoV2 infection or vaccination in asymptomatic adolescents: insights from the EnIGMA study

Abstract Background Myocarditis after SARS-CoV2 infection or vaccination is rare, but seems to be relatively more frequent in young population. Cardiac magnetic resonance (CMR) T2 weighted sequences have the potential to detect subclinical myocarditis. However, there is paucity of data on the potential myocardial involvement after SARS-CoV2 infection or vaccination in asymptomatic adolescents. Purpose To evaluate the presence of subclinical myocardial damage in adolescents who were infected with SARS-CoV2 or vaccinated against SARS-CoV2 using non-contrast CMR imaging. Methods Asymptomatic adolescents enrolled in the “Early ImaginG Markers of unhealthy lifestyles in Adolescents” (EnIGMA) project were scanned using a 3-Tesla CMR scanner between March 2021 and October 2021. CMR scans included CINE imaging and myocardial T2-mapping sequences. SARS-CoV2 IgG antibody testing was performed in capillary blood samples, and date of confirmed SARS-CoV2 infection and/or vaccination if any was collected. Participants were assigned to three different groups according to SARS-CoV2 status: Group 1 (non-infected and non-vaccinated), Group 2 (infected and non-vaccinated), and Group 3 (vaccinated, independently of past infection status). CMR images were analyzed by experienced observers blinded to adolescent's SARS-CoV2 status. ANOVA and multiple regression analysis, together with correlation coefficients, were used to study between-group differences and associations among variables of interest. Results A total of 115 adolescents with a mean age of 16.0 years (standard deviation (SD)=0.4), 54% girls, completed the CMR study and SARS-CoV2 data successfully, and were assigned to Group 1 (n=72), Group 2 (n=22), and Group 3 (n=21). Left and right ventricular ejection fraction (LVEF/RVEF) did not significantly differ among groups: mean LVEF was 62.8% (SD=4.1), 63.0% (SD=3.7) and 60.9% (SD=3.9) [p=0.12] and mean RVEF was 56.5% (SD=4.2), 56.5% (SD=5.5) and 54.5% (SD=5.1) [p=0.23] in Groups 1, 2 and 3, respectively. Similarly, there were no between-group significant differences in myocardial T2 relaxation values: mean T2 values were 44.1 ms (SD=2.2), 44.1 ms (SD=1.8) and 44.4 ms (SD=1.9) in Groups 1, 2, and 3, respectively (p=0.63) (Figure 1). No differences were found either after adjusting for age and gender. Median time (interquartile range) from date of infection or vaccination to CMR acquisition was 133 (121) days and 28 (38) days in Group 2 and Group 3, respectively. No correlation between time from infection/vaccination to CMR acquisition and T2 values was detected (Figure 2). Conclusions This observational study did not find evidence of subclinical myocardial involvement after SARS-CoV2 infection or vaccination in asymptomatic adolescents, as assessed with T2-mapping magnetic resonance imaging. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Instituto de Salud Carlos III (ISCIII)-Fondo de Investigaciόn Sanitaria.European Regional Development Fund/European Social Fund (“A way to make Europe”/“Investing in your future”.

MULTIPLE TROMBOSIS IN CHILD WITH POST COVID-19 INFECTION

Introduction: SARS CoV-2 infection can cause acute, as well as chronic damage to the cardiovascular system. Blood vessel dysfunction and clot formation, as suggested by elevated D-dimer levels, are thought to play a significant role in morbidity, as well as in mortality in Covid-19 patients, leading to clots causing pulmonary embolisms and ischemic events within the brain1. Aim: To confirm the correlation between SARS CoV-2 infection and possibility for vascular complication, including thrombotic brain lesion. Materials: Detailed patient’s history, physical examination particularly noting the neurological status and locomotor skills, as well as blood analysis with hemostasis and d-dimers, serology for SARS CoV-2 IgG antibodies and PCR swab were all part of the diagnostic process for this patient. Methods: Computed tomography and brain MRI with angiography were main imaging tools used in the diagnostic process. Results: Thrombosis of the left middle cerebral artery was confirmed on brain MRI with angiography in a patient recovered from SARS CoV-2 infection, noted with high levels of IgG antibodies to the particular virus and elevated D-dimer levels, presenting with symptomatic right sided hemiparesis. Conclusion: Some of the patients recovered from SARS CoV 2 infection can develop ischemic stroke. This link is confirmed by elevated levels of IgG antibodies in patient’s serum against SARS CoV-2. This kind of vascular post viral complication can cause different kind of disability, presented with neurological impairment and coagulation disorders. The prognose is improving with anticoagulant and physical therapy started early.2 Keywords: Thrombosis, SARS Cov-2, Brain, Hemiparesis

Antibody response to the COVID-19 ChAdOx1nCov-19 and BNT162b vaccines after temporary suspension of DMARD therapy in immune-mediated inflammatory disease (RESCUE).

ObjectiveTo assess the antibody response to disease-modifying antirheumatic drug (DMARD) therapy after the first and second dose of the ChAdOx1nCov-19 (AstraZeneca (AZ)) and BNT162b (Pfizer) vaccines in patients with immune-mediated inflammatory disease (IMID) compared with controls and if withholding therapy following the first vaccination dose has any effect on seroconversion and SARS-CoV-2 antibody (Ab) levels.MethodsA multicentre three-arm randomised controlled trial compared the immunogenicity of the Pfizer and AZ vaccines in adult patients on conventional synthetic (csDMARD), biologic (bDMARD) or targeted synthetic (tsDMARD) therapy for IMID (n=181) with a control group (n=59). Patients were randomised to continue or withhold DMARD therapy for 1–2 weeks post first dose vaccination only. Serum SARS-CoV-2 IgG detection (IgG ≥1.0 U/mL) and titres against the S1/S2 proteins were measured at baseline, 3–4 weeks post first vaccination and 4 weeks post second vaccination.ResultsAZ vaccination was given to 47.5%, 41.5% and 52.5% in the continue, withhold and control groups, respectively while Pfizer vaccination was given to 52.5%, 58.5% and 47.5% among the continue, withhold and control groups, respectively. Seroconversion rates following the first dose in the AZ and Pfizer groups were only 27.3% vs 79.2% (p=0.000) and 64.58% vs 100% (p=0.000), respectively in the IMID groups who continued therapy compared with the AZ and Pfizer controls, respectively. Withholding DMARD therapy following the first vaccination dose resulted in higher seroconversion to 67.7% and 84.1% in the AZ and Pfizer groups, respectively. Following the second AZ and Pfizer vaccinations when all DMARDs were continued, despite a slightly lower seroconversion rate (83.7% vs 100%, p=0.000 and 95.9% vs 100%, p=0.413), respectively, the mean SARS-CoV2 IgG Ab titres were not significantly different in the csDMARD and bDMARD groups compared with the controls regardless of hold while it was significantly lower in patients taking tsDMARD (12.88 vs 79.49 U/mL, p=0.000).ConclusionsFollowing the first vaccination dose, antibody responses were lower in IMID on DMARD therapy, however the final responses were excellent regardless of hold with the exception of the tsDMARD group where withholding therapy is recommended. At least 2 vaccinations are therefore recommended preferably with an messenger RNA vaccine.Trial registration numberANZCTR: 12621000661875.

Case Report Chest Non-contrast ct-scan findings and follow up a patient suspected covid-19 infection

Background Covid-19 is an infection caused by SARS-CoV-2. Chest X-Ray (CXR) examination doesn’t show the radiographiccharacteristic of Covid-19 infection. Thorax CT-Scan is the gold standard imaging for pneumonia Covid-19 infection.Aim The purpose of this report is to describe a case of bronchopneumonia in a male patient aged 48 years old at Bethesda Hospital Yogyakarta during the Covid-19 pandemic.Case Description A 48 years old male patient came to the Bethesda Hospital in Yogyakarta with a complaint of fever 1 week before being hospitalized. The patient also complained of cough, sore throat, rhinorrhea, shortness of breath, malaise, and decreased appetite. The rapid test result shows SARS-CoV2 IgM and IgG (+), PCR swab Covid-19 results (+). Bronchopneumonia was concluded by CXR examination and chest non-contrast CT-Scan showed Covid-19 infection imaging characteristics. Later on, the patient showed clinical and radiological improvement.Conclusion Covid-19 is an infection caused by the SARS-CoV-2. Common symptoms are fever, cough, sore throat, shortness of breath, and malaise. CXR examinations on patients with Covid-19 infection show images of pneumonia, in this case, bronchopneumonia was concluded. CT-scan shows characteristic imaging of Covid-19 infection can support the decision on regular ward admission versus ICU and for follow-up in regular ward admission.

Incidence of SARS-CoV-2 Infection among Healthcare Personnel after Restarting an Elective Cataract Surgery during the First COVID-19 Wave

Background: During the COVID-19 pandemic, most elective surgeries were postponed, including cataract surgery. However, patients with severe and disabling visual impairment may have required urgent correction. Objective: To report the incidence of SARS-CoV-2 infection among healthcare personnel working with the patients requiring cataract surgery, under a pre-operative screening protocol. Materials and Methods: A retrospective observational study was conducted in the Suddhavej Hospital, Mahasarakham University, Mahasarakham, Thailand during the early unlocked phase in May 2020. The local pre-operative screening protocol used during the period included questionnaires and pre-operative nucleic acid testing to screen for COVID-19 infection among patients. A combination of serial single nucleic acid test and SARSCoV-2 IgG antibody testing were used to screen SARS-CoV-2 infection among healthcare personnel. Mask wearing and physical distancing were required during hospitalization. Results: One hundred fifty-eight patients underwent cataract surgery under local anesthesia. Thirty-three healthcare personnel were included. All tests for SARS-CoV-2 were negative for both patients and healthcare personnel. The incidence rate of COVID-19 infection among healthcare personnel was 0 (95% CI 0.000 to 0.003) per 100 person-hours. There were no reported symptoms compatible with COVID-19 during the observed period and follow-up. Conclusion: Due to a very low incidence rate of hospital-acquired SARS-CoV-2 infection among healthcare personnel, elective cataract surgery under local anesthesia could be continued during COVID-19 pandemic with strict adherence to screening protocol and other preventive measures. SARS-CoV-2 screening method by questionnaire alone may be feasible in a low COVID-19 incidence rate. Keywords: Cataract surgery; COVID-19; Pre-operative SARS-CoV-2 screening; Pool PCR testing; In-hospital transmission

Role of serology tests in COVID-19 non-hospitalized patients: A cross-sectional study.

IntroductionSevere acute respiratory syndrome coronavirus (SARS-CoV2) has imposed catastrophic impressions on the world. After all the focused researches conducted in the COVID-19 area, many features remain obscure. We have surveyed 1,363 outpatients with suspected COVID-19 in Tehran, Iran. The analysis emphasized on characteristics of patients with positive PCR or serology of SARS-CoV-2.MethodsThe nasopharyngeal swabs were tested for SARS-CoV2 PCR. Serum specimens were tested for SARS-CoV2 IgG and IgM. Clinical presentations of the patients, history of chronic diseases or drug use, contact with a possible COVID-19 patient and previous infection with SARS-COV2 were investigated.ResultsOf the total 1,363 investigated patients, 22% had positive SARS-CoV-2 PCRs, 82% had positive IgG, 38% had positive IgM, and 31% had both positive IgM and IgG values. Positive serologic tests were significantly associated with a positive PCR test obtained previously in the course of the current disease (P value<0.001).IgG and IgM antibody values were significantly associated with underlying disease, cough, fever, chills, fatigue, and myalgia (all P values <0.001). Dyspnea was significantly associated with IgG levels (P value = 0.01), yet it was not associated with IgM serology (P value = 0.2). Positive serology tests were not associated with symptoms of coryza.GI symptoms were not associated with positive IgG test (P value = 0.1), yet it did show an association with positive IgM test (P value = 0.02).Cough, fever, chills, myalgia fatigue, dyspnea, and GI symptoms were all significantly associated with positive PCR (all P values <0.001), and symptoms of coryza did not show a significant relationship (P value = 0.8).ConclusionAssessing antibody titers in outpatients is invaluable due to the epidemiological importance of investigations in mild or even asymptomatic cases. Since the number of such studies in non-hospitalized patients is not high, the current study can be used as a comparison model.

Mutation Occurrence in Tor2 Gene in Patients with SARS COV-2 in Association with H. Influenza Infection

SARS COV-2is a very dangerous virus that has led to many deaths. H. Influenzais a bacteria that causes many infections inside the human body, such as pneumonia. In this study, a total of (60)blood samples were taken from patients infected with SARS COV-2shared with H. Influenza infection who attended Ibn-Al-Baladi Hospital/Baghdad city during the period from 15th January to 1st December 2021. Venous blood samples were also taken from (60) healthy individuals as a control group. The results showed that the distribution rate of the SARS COV-2 IgG and H. influenza IgG among the male patients was twice44 (73.3%)more than the distribution rate among female patients. The prevalence of SARS COV-2 IgG and H. influenza IgG was shown to be the highest among the age group (&gt;51) years, followed by the age group (21-30) years. The cases of SARS COV-2and H. influenza infections among the studied patients according to residency were shown to be almost equal among rural and urban residents 30,30 (49.2%,50.8%) respectively. Regarding the relationship between SARS COV-2 IgG and H. influenza IgG and CRP levels, the mean level of CRP in the patients was (73.72±17.05) and in the the controls was (8.71±1.12), while the mean level of H. influenza IgG in the patients was (1.05±0.23) and in the control group was (0.3±0.02), whereas the mean level of SARS COV-2 IgG was (7.00±2.15) in the patients andwas (0.35 ±0.19) in the controls with a highly significant differences (HS).The number and percentage of patients with positive SARS COV-2 and H. influenza IgG was 38(95.0%) who had high levels of GOT up to 65 U/L, while 2(50%) of those patients had GOT &gt;65 U/L, while the Negative infections with SARS COV-2 IgG, H. influenza IgG 17(85.0%) had up 65 U/L and 3(15.0 %) had&gt;65 U/L level (P =0.03).In addition, high levels of GPT, Alkaline phosphates, urea and creatinine were recorded among patients groups when compared with the healthy controls.

Patients that are having Covid-19 Disease After the First Dose of Covid-Vaccine

There is no effective treatment for the Covid-19 disease that is still impacting the whole world. It considered that vaccines, one of the effective means to prevent infectious diseases, will play a significant role in protecting from the Covid-19 Disease. Vaccinations generals performed before exposure. We aimed to follow the clinical and laboratory progress of patients who got Covid-19 after the first dose of the Covid-19 vaccine and to evaluate the changes that may occur in antibody formation. 13 patients, who received the first dose of COVID 19 vaccine Coronovac as of 14.01.2021 when vaccination started in Adıyaman University Training and Research Hospital/Turkey, who had symptoms after the vaccine and whose real-time PCR found to be positive, were included in the study. After the first dose of the Covid-19 vaccine, 13 patients exam. Three of our patients were female, and 10 of them were male. The average age was 38.8. British variant detected in 4 of our patients; 1 of them was female. Contact times differed between 3 and 5 days. The most common symptoms were muscle-joint pain (53.8), weakness-fatigue (46.2), fever (38.5), and headache (30.8). Three of our patients, being one female, received inpatient treatment. Furthermore, our five patients who checked regarding Sars cov-2 IgG became positive in the first month. No adverse changes in the course of the illness observed in the patients were RT-PCR positive after the first dose of the Covid-19 vaccine. Antibody response detected at the end of the first month. Vaccination is an effective method for taking infectious diseases under control but adhering to personal protective measures still maintains their importance.

Seroconversion and side effects after COVID vaccination among persons with type 2 diabetes in urban, rural, and tribal areas in Kerala, India.

Persons with type 2 diabetes mellitus (T2DM) are at high-risk for COVID-19 infection and are a priority group for vaccination. The objective of this study is to estimate the seroconversion and determine the side effects after COVID-19 vaccination among persons with T2DM in urban, rural, and tribal areas in Kerala. A cross-sectional study was conducted in urban, rural, and tribal field practice areas of a medical college in Central Kerala, among 396 persons with T2DM. The participants were selected by simple random sampling from the 200-250 diabetic patients visiting each health center. Qualitative and quantitative estimation of antibodies were done by WANTAI Ab enzyme-linked immunosorbent assay kit and Abbott SARS COV-2 IgG Quantitative assay, respectively. The mean age of the respondents was 59.40 ± 12.25 years. A majority (65.5%) had received both doses of vaccine. About half (51.5%) experienced side effects after vaccination. Antibodies (IgG or IgM) were detected in 93.2% (95% confidence interval [CI] 90.2, 95.5) of participants. Those with a duration of diabetes ≥5 years, with a single dose of vaccine, were five times (adjusted odds ratio [aOR] - 5.23,95% CI 1.86, 14.66) and four times (aOR - 4.11, 95% CI 1.66, 10.13) more likely, respectively, to be seronegative. Those who took medication for diabetes were protected against a no antibody (aOR - 0.05, 95% CI 0.02, 0.148) response. The median antibody titer in a subset (150) of participants was 365.2 (90-1587) AU/ml. Past COVID infection was an independent determinant of high IgG titers (aOR - 4.95, 95% CI 1.50, 16.36). Reinforcing the importance of vaccination particularly among those with longer duration of diabetes is imperative.

Humoral and cellular immunity in convalescent COVID-19 people with multiple sclerosis treated with ofatumumab

ObjectivesTo report clinical outcome, development of humoral and T-cell mediated immunity in convalescent COVID-19 people with multiple sclerosis (pwMS) treated with ofatumumab in the ALITHIOS study from a single center. MethodsTesting for SARS-Cov2 IgG antibodies was performed on two occasions with at least three months apart between the two testing. During the second antibody testing, interferon-γ ELISpot was used to assess cellular immunity. ResultsAll four subjects had mild COVID-19 infection without any sequelae. In all subjects except subject 2, COVID-19 was confirmed with PCR. Subjects 1, 2 and 4 had normal levels of IgM and IgG without measurable counts of CD19 cells prior to COVID-19. Subject 3 administered the last dose of ofatumumab 24 days prior to COVID-19 symptoms, but had a gap of 28 weeks of ofatumumab application beforehand due to low IgM levels. Subject 4 received COVID-19 vaccinations before second testing, so second testing and T-cell immunity testing were not performed. Subjects who were CD19 depleted did not had measurable levels of SARS-Cov2 IgG antibodies. Subject 3 had first and second SARS-COV2 titer of 118 U/ml and > 250 U/ml, respectively. All three pwMS showed T cell immunity against SARS-CoV-2. Quotient of basal spots divided by interferon-γ secreting spot forming units were 4, 8 and 14.7 SI in subjects 1, 2 and 3, respectively (>3 considered reactive). ConclusionWhile no antibody response was observed in pwMS who were CD19+ lymphocyte depleted, T cell immunity against SARS-CoV-2 was observed in all three pwMS treated with ofatumumab.